Are Continuity Clinic Patients Less Satisfied When the Resident Is Postcall?

Due to recent public debate and newly imposed resident work hour restrictions, we decided to investigate the relationship of resident call status to their ambulatory patients' satisfaction. Resident continuity clinic patients were asked to rate their level of satisfaction on a 10-point Likert-type scale. Using multiple regression approaches, these data were then assessed as a function of resident call status. We found that in 646 patient encounters, patient satisfaction scores were significantly less when the resident was postcall, 8.99 ± 1.8, than when not postcall, 9.31 ± 1.3. We herein discuss etiologies and implications of these findings for both patient care and medical education.     

腮腺导管癌的临床病理特征分析--附1例报告及文献复习

目的:结合文献探讨腮腺导管癌的临床病理特征。方法:报道1例腮腺导管癌，就本病的临床生物学特征、病理、治疗及预后进行总结分析。结果:经手术及放疗后3个月复查，出现同侧颈部淋巴结转移。结论:腮腺导管癌是一类恶性度很高的恶性肿瘤，诊断主要依靠术后病理学及免疫组织化学检查，以局部广泛切除加颈廓清术为主，术后给予放疗。     

肺鳞状细胞癌81例临床分析

目的 分析81例肺鳞状细胞癌（鳞癌）临床特征，提高早期诊治率。方法 回顾性分析81例肺鳞癌诊断、手术、治疗及随访资料。结果 患者平均年龄62岁，男：女为2．2：1，有吸烟史76例（93．8％），平均26年，全组均有呼吸道症状，合并全身症状14．8％（12例）。确诊时间2～7个月。手术切除病肺63例（77．8％），术后放、化疗。未能切除18例中10例放、化疗。随访中位数5年以上。80例得到随访，1、3、5年生存率为90％（72例）、65％（52例）、47．5％（38例）。结论 肺鳞癌以老年男性多见，易误诊，手术切除率低，早期手术5年生存率高。     

Doctor – How do I use my EpiPen?

Parents and children who have been prescribed an Epipen are often unable to demonstrate its correct administration. One contributory factor may be that doctors are unfamiliar with the EpiPen and are unable to demonstrate the correct administration of the pen to the family. The aim of this study was to determine the rate of correct EpiPen demonstration by junior and Senior Medical Staff at a major tertiary paediatric Hospital. Junior and Senior medical staff were scored on their ability to correctly use the EpiPen trainer. A 6 step scoring system was used. One-hundred doctors were recruited (Residents n = 31, Senior Residents n = 39, Fellow/Consultants n = 30). Junior and Senior Medical staff had similar scores for EpiPen demonstration, the number that needed to read the EpiPen instructions prior to use and the frequancy of accidental self-injection into the thumb. Only two doctors (2%) demonstrated all 6 administration steps correctly. The most frequent errors made were not holding the pen in place for >5 seconds (57%), failure to apply pressure to activate (21%), and self-injection into the thumb (16%). Ninety five doctors needed to read the instructions, and of these, only 39 (41%) then proceeded to correctly demonstrate the remaining 5 steps. Forty-five doctors had previously dispensed an EpiPen, but only three demonstrated its use to parents/children with a trainer. The majority of doctors do not know how to use an Epipen and are unable to provide appropriate education to parents/children. In 37% of cases, the demonstration would not have delivered adrenaline to a patient.     

通气模式名称与临床应用

呼吸机通气模式名称的不统一或说混乱,给临床使用呼吸机带来了很大困难,严重影响了紧急情况下的抢救工作。     

开展研讨式生物化学论坛,培养医学八年制学生科研思维能力

在医学基础课程学习阶段形成一定的科研思维体系,对医学八年制学生而言至关重要。笔者在医学八年制生物化学教学中,以理论课所教授知识为基础,引导学生提出问题,在老师的指导下开展研讨式论坛,从而培养学生形成自主科研思维体系,为今后全面提高科研创新能力打下坚实基础。     

131Ⅰ治疗分化型甲状腺癌的单病种临床路径优化

目的探讨^131I治疗分化型甲状腺癌的临床诊疗程序,优化单病种临床路径。方法使用放射性核素^131I治疗14例分化型甲状腺癌患者,观察患者的治疗反应及对症处理,优化临床路径。结果对分化型甲状腺癌^131I治疗的术前准备、常规医嘱、临床观察、疗效评估、护理、治疗注意事项等方面进行优化。结论^131I治疗分化型甲状腺癌疗效肯定,在满足条件的医院,可广泛开展。     

Ortho Biovue正定型血型卡临床应用评价

目的探讨Biovue正定型血型卡在临床应用中鉴定血型的准确性。方法用试管法和卡式法(Biovue卡)两种方法鉴定522例我院住院患者和门诊健康体检者,按性别、年龄、标本状况、血型、健康状态分成5组进行统计,比较这5组中两种方法的检测结果,计算出卡式法鉴定血型的准确率。结果性别、年龄、标本状况、血型、健康状况5组中两种方法的检测结果完全一致,卡式法鉴定血型的准确率达到100%。结论卡式法中试剂和样本均定量加入,而且消除了显微镜下的人为影响因素,其检测结果趋于标准化。本研究发现该法检测结果准确可靠,能满足临床需要。     

青年医师如何看待医疗纠纷

作者针对青年医师面对医疗纠纷的困惑,从各角度分析了医疗纠纷的成因,指出应以正向心态对待医疗纠纷。